Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | RBT-19-108572 | MO |
NPI | 1003440132 |
---|---|
Provider Name | Jennifer Barnes |
First Address | Olivette, MO 63132-3253 |
Second Address | Olivette, MO 63132-3253 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2020 |
Last Update Date | 27/02/2020 |